Educational interventions on reducing antibiotic over-prescribing among children with upper respiratory infections (URIs)

Conditions

Upper respiratory infections (URIs) among children, which includes: acute URIs, common cold, acute tonsillitis and acute pharyngitis Respiratory

Xiaolin Wei, Zhitong Zhang, Joseph Paul Hicks, John Walley, Rebecca King et al. (12 authors)

PLoS Medicine2019-02-0591 citations

10.1371/journal.pmed.1002733

Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial.

Wei X, Zhang Z, Walley JD, Hicks JP, Zeng J, Deng S, Zhou Y, Yin J, Newell JN, Sun Q, Zou G, Guo Y, Upshur REG, Lin M.

2017-11-0587 citations

10.1016/s2214-109x(17)30383-2

Protocol for a pragmatic cluster randomised controlled trial for reducing irrational antibiotic prescribing among children with upper respiratory infections in rural China

Guanyang Zou, Xiaolin Wei, Joseph Paul Hicks, Yanhong Hu, John Walley et al. (15 authors)

BMJ Open2016-05-0112 citations

10.1136/bmjopen-2015-010544

Interventions

Current interventions as of 03/07/2017: The township hospitals randomly allocated into the intervention group will receive the educational intervention for both clinicians and parents.

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Current inclusion criteria as of 03/07/2017: All eligible township hospitals from the two selected counties of Guangxi who agree to participate in the study will be included. The two counties should have implemented the Essential Medicine List and Zero-markup policy in 2012. Intervention: 1. Township hospitals: 25 township hospitals in two selected counties 2. Parents/caregivers: who have been taking care of children between 2 and 14 years old 3. Doctors: pedestrian or internal medicine clinician who is seeing children between 2 and 14 years old Research: 1. Parents/caregivers: 2 parents/caregivers per township hospital in 6 township hospitals selected for process evaluation. 2. Doctors: 1 township hospital director and 3 clinicians per township hospital in 6 township hospitals selected for process evaluation. 3. Prescriptions: 200/township hospital (before and after intervention respectively) Previous inclusion criteria: All eligible township hospitals from the two selected counties of Guangxi who agree to participate in the study will be included. The two counties should have implemented the Essential Medicine List and Zero-markup policy in 2012. Intervention: 1. Township hospitals: 25 township hospitals in two selected counties 2. Parents/caregivers: who have been taking care of children between 2 and 14 years old 3. Doctors: pedestrian or internal medicine clinician who is seeing children between 2 and 14 years old Research: 1. Parents/caregivers: 6-8 parents/caregivers in each focus group discussion 2. Doctors: 1 township hospital director and 2 clinicians in each township 3. Prescriptions: outpatients: 40/township (before and after intervention), inpatients: 200/township (before and after intervention)

Exclusion criteria

Exclusion criteria: 1. Prescriptions for children diagnosed with diseases such as tuberculosis, HIV/AIDS or other immunodeficiency disease, any form of cancer, dyslipidaemia, chronic heart diseases, and pneumonia, who need long-term antibiotic treatment or prophylaxis 2. Children =2 years old and >14 years old will be excluded

Design outcomes

Primary

Measure	Time frame
Current primary outcome measures as of 03/07/2017: Antibiotics prescription rate (APR) of outpatient childhood URIs between 2-14 years old, measured at baseline (3 months prior to the intervention) and endline (last 3 months during intervention period) Previous primary outcome measures: Antibiotics prescription rate (APR) of outpatient childhood URIs between 2-14 years old, measured at baseline (3 months prior to the intervention), 3 months after the intervention and 6 months after the intervention	—

Measure

Time frame

Current primary outcome measures as of 03/07/2017: Antibiotics prescription rate (APR) of outpatient childhood URIs between 2-14 years old, measured at baseline (3 months prior to the intervention) and endline (last 3 months during intervention period) Previous primary outcome measures: Antibiotics prescription rate (APR) of outpatient childhood URIs between 2-14 years old, measured at baseline (3 months prior to the intervention), 3 months after the intervention and 6 months after the intervention

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Secondary

Measure	Time frame
Current secondary outcome measures as of 03/07/2017: Measured at baseline (3 months prior to the intervention) and endline (last 3 months during intervention period): 1. Two and more than two antibiotic combination prescription rate 2. Broad-spectrum antibiotic use rate of outpatient prescriptions 3. Injectable antibiotic prescription rate 4. Quinolones use rate 5. Average cost of a prescription Previous secondary outcome measures: Measured at baseline (3 months prior to the intervention), 3 months after the intervention and 6 months after the intervention: 1. Two and more than two antibiotic combination prescription rate 2. Broad-spectrum antibiotic use rate of outpatient prescriptions 3. Quinolones use rate 4. Average cost of a prescription 5. Antibiotics prescription rate of inpatient childhood URIs 6. Appropriateness of antibiotics use among inpatient childhood URIs	—

Measure

Time frame

Current secondary outcome measures as of 03/07/2017: Measured at baseline (3 months prior to the intervention) and endline (last 3 months during intervention period): 1. Two and more than two antibiotic combination prescription rate 2. Broad-spectrum antibiotic use rate of outpatient prescriptions 3. Injectable antibiotic prescription rate 4. Quinolones use rate 5. Average cost of a prescription Previous secondary outcome measures: Measured at baseline (3 months prior to the intervention), 3 months after the intervention and 6 months after the intervention: 1. Two and more than two antibiotic combination prescription rate 2. Broad-spectrum antibiotic use rate of outpatient prescriptions 3. Quinolones use rate 4. Average cost of a prescription 5. Antibiotics prescription rate of inpatient childhood URIs 6. Appropriateness of antibiotics use among inpatient childhood URIs

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Countries

China

Outcome results

None listed